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J Neurol Neurosurg Psychiatry 2007;78:929-935 doi:10.1136/jnnp.2006.106914
  • Paper

Quantitative gait dysfunction and risk of cognitive decline and dementia

  1. Joe Verghese1,
  2. Cuiling Wang2,
  3. Richard B Lipton1,
  4. Roee Holtzer3,
  5. Xiaonan Xue2
  1. 1Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, Bronx, New York, USA
  2. 2Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, Bronx, New York, USA
  3. 3Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
  1. Correspondence to:
 Dr Joe Verghese
 Einstein Ageing Study, Albert Einstein College of Medicine, 1165 Morris Park Avenue, Room 338, Bronx, New York 10461, USA; jverghes{at}aecom.yu.edu
  • Received 14 September 2006
  • Accepted 9 January 2007
  • Revised 26 December 2006
  • Published Online First 19 January 2007

Abstract

Background: Identifying quantitative gait markers of preclinical dementia may lead to new insights into early disease stages, improve diagnostic assessments and identify new preventive strategies.

Objective: To examine the relationship of quantitative gait parameters to decline in specific cognitive domains as well as the risk of developing dementia in older adults.

Methods: We conducted a prospective cohort study nested within a community based ageing study. Of the 427 subjects aged 70 years and older with quantitative gait assessments, 399 were dementia-free at baseline.

Results: Over 5 years of follow-up (median 2 years), 33 subjects developed dementia. Factor analysis was used to reduce eight baseline quantitative gait parameters to three independent factors representing pace, rhythm and variability. In linear models, a 1 point increase on the rhythm factor was associated with further memory decline (by 107%), whereas the pace factor was associated with decline on executive function measured by the digit symbol substitution (by 29%) and letter fluency (by 92%) tests. In Cox models adjusted for age, sex and education, a 1 point increase on baseline rhythm (hazard ratio (HR) 1.48; 95% CI 1.03 to 2.14) and variability factor scores (HR 1.37; 95% CI 1.05 to 1.78) was associated with increased risk of dementia. The pace factor predicted the risk of developing vascular dementia (HR 1.60; 95% CI 1.06 to 2.41).

Conclusion: Our findings indicate that quantitative gait measures predict future risk of cognitive decline and dementia in initially non-demented older adults.

Footnotes

  • Published Online First 19 January 2007

  • Funding support: The Einstein Ageing Study is funded by the National Institute on Ageing (grant AG03949). Dr Verghese is funded by the National Institute on Ageing (grants K23 AG024848 and RO1 AG025119).

  • Competing interests: None.

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